- In patients with metastatic or advanced colorectal cancer (CRC), continuous intravenous (cIV) 5-fluorouracil (5-FU) is associated with better response rates and fewer adverse events than capecitabine.
- Survival outcomes were similar.
Why this matters
- This is the first meta-analysis to specifically examine capecitabine and cIV 5FU, which are the most commonly used fluorouracil modalities.
- Meta-analysis of 23 studies (n=10,105).
- Funding: National Natural Science Foundation of China; Fundamental Research Funds for the Central Universities, Baxter (China).
- The response rate was lower in the capecitabine-based regimen (n=3786; relative risk [RR], 0.9; P=.01).
- Effect was significant when regimens were combined with oxaliplatin (RR, 0.90; P=.04), but not when combined with irinotecan (RR, 0.91; P=.13).
- There was no significant difference in PFS, time to treatment failure, OS, or DFS.
- Capecitabine was associated with more grade 3/4 AEs:
- Diarrhea: RR, 1.68 (P<.001 irinotecan: rr>
- Vomiting: RR, 1.30 (P=.006); with irinotecan: RR, 1.87.
- Nausea: RR, 1.34 (P<.001 irinotecan: rr>
- Hand-foot syndrome: RR, 5.46; P<.001.>
- Thrombocytopenia: RR, 1.62; P=.02;
- Dehydration: RR, 2.33 (P<.001 irinotecan: rr>
- Treatment regimen heterogeneity.